Posted 4 years ago on Sept. 20, 2012, 7:05 p.m. EST by Doglover
(10)
from Denver, CO
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September 19, 2012

The Emerging Obamacare Truth Is Disarray

By Scott Gottlieb

A remarkable truth about Obamacare is how many aspects of its initial programs and initiatives are already in disarray.

The Obama team is woefully behind its own schedule for implementing features of the legislation. The critical regulations outlining what the Obamacare insurance benefit will look like was supposed to be out more than six months ago. Now it looks like this regulation won't be dropped until after the election. This is just one key aspect of the program that is way behind the administration's own timeline.

These facts alone should give proponents of the law pause. But the early experience with the elements of Obamacare that have already kicked in is downright dismal.

The core of Obamacare doesn't get started until 2014, when state-based exchanges are supposed to be formed as places for consumers to buy the legislation's tightly regulated, subsidized coverage. But early features of Obamacare are already failing.

· The temporary "high risk" pools that Obamacare created, to provide a way for those with pre-existing health conditions to get insurance immediately, are undersubscribed yet way over budget. The Congressional Budget Office estimated that the $5 billion allocated to these pools could enroll 200,000 consumers. They envisioned enrollment growing to more than 400,000. But only 77,877 have signed up as of July, yet the program is way over its budget. More than a quarter of these state-based risk pools are short on cash.

· The CLASS Act, which was supposed to provide consumers government-financed long-term care insurance has been abandoned, blowing an $86 billion dollar hole in Obamacare's cost estimates. The CLASS Act was never financially viable. Its costs would have outstripped revenue as soon as it was in full operation. But since it took in money five years before it started to pay out benefits, budget gimmickry let Mr. Obama capture that revenue and use it to finance Obamacare. In abandoning the measure, the President's own health secretary called the scheme "unsustainable."

· The crown jewel of Obamacare's effort to contain healthcare costs, the creation of Accountable Care Organizations, is so unwieldy that major provider groups have said they won't participate. The idea is to consolidate doctors, turning them into employees of large systems, and then pay these systems lump sums of money to take care of groups of patients. A letter from 10 major medical groups that previously ran similar programs said, "it would be difficult, if not impossible" to accept the financial design created by Obamacare. In another rebuke, an umbrella group representing premier medical organizations said 90 percent of its members wouldn't partake.

· New regulations Obamacare puts on insurers have been so unworkable that the Obama team has had to dole out 1,231 waivers. These exemptions are granted when the Obamacare rules are projected to raise healthcare premiums more than 10 percent, or create a "significant decrease in access to healthcare benefits." These waivers haven't been doled out consistently. Entities winning the preferences are over-represented by plans offered by unionized businesses and other administration allies.

· Obamacare can't even settle on an affordable definition to the term "affordable" -- creating the prospect that millions of middle class families will get priced out of coverage. According to a recent editorial in the New York Times, "the people left in the lurch would be those who had lower incomes but were not poor enough to qualify for Medicaid." Because of the way Obamacare defines what's "affordable" to these families, many working-class people would be unable to afford family coverage offered by their employers, and yet they would not qualify for subsidies provided by the law.

Probably out of recognition of this poor track record, the President points largely to the insurance reforms he passed when he is stumping for Obamacare. The story isn't much better here. Some of these new rules cost insurers money, such as regulations ending lifetime limits on medical claims. Others, such as enabling young adults to remain on their parents' policies, can be downright lucrative. But these popular changes, which Mr. Obama touts as a success, have also been badly implemented.

We're in a terrible economic climate, where medical utilization trends are way down. The cost of healthcare coverage should be falling as well. But premiums have risen far faster than overall inflation or GDP growth since Obamacare's passage. The regulations kicked in with no offsetting incentives to get people into the insurance pool to help absorb the costs. If the President wants to take credit for these costly insurance market reforms, he also has to accept blame for the rising costs.

So what's left for the President to tout?

Not much. Obamacare isn't even in full swing, and at every turn, the program is crumbling. The President's team is banking on a second term to try and right all of its fiascos but there's an emerging truth that the scheme is simply unworkable.

American Enterprise Institute (AEI) Resident Scholar Scott Gottlieb, M.D. is a practicing physician. He previously served in senior positions at the Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS).

You can't have everything that was campaigned on, though. I mean, we got assassinations, ramping up drone strikes (even on Americans), potential indefinite detention of Americans signed into law, Gitmo operating smoothly, selling weapons to rebels in other countries, militarization of the police, prosecuting a record number of whistleblowers, smuggling weapons into mexico, handing more money to banks, letting the Federal Reserve destroy the currency...

Have you counted the sources/links identified for the claims in the article? The poster cut and pasted a column without expressing any personal thought or reaction to the content. Where is the insult? And you criticize me?

Some of the issues identified have been caused by GOP governors avoiding implementing what would help their people for purely political/ idealogical purposes.. Sure there will be consequences, this or next election, as it starts to show adverse consequences but their people are hurting now.

Counter arguments are fine and I have posted dozens re healthcare. I was suggested that they are out there and readily available if this duffous was actually ignorant of them, and interested in actually learning about it. I think it is obvious that the poster is displaying, shall we say, willful ignorance and I am tired of playing it straight with people who lie. I am an old man, and I don't suffer fools well anymore. I have beaten cancer, I think, and my wife just had her last chemo treatment. Radiation is next. So, you go ahead and tilt with those windmills, Mr. Quixote, and I will cheer occasionally from the safety of the sidelines.

In NY we're already losing nursing positions as subsidies to hospitals are being cut. It's probably for the best, though, that we reduce them to poverty since these working class people are the very ones who will fall between the cracks with Obamacare. And that appears to be the mentality here - they are just collateral damage in an effort to buy the vote; is an appealing economically feasible approach even possible in a country of open borders with a population in the hundreds of millions headed by a partisan government owned by corporations? I'd say, no f*cking way.

My neighbor told me he just had an operation on his prostate. I was surprized to find out he didn't have HC insurance. He's 63 and he was waiting for Medicare to kick in two years. He's OK but he wishes he had done something sooner. He owes $50,000 now.

Sure, turn them off. Heaven forbide that i might hear all sides talk and possibly change my opinions. Might force me to have to think instead of just react and i know the thought of that scares the heck out of you. Stay safe in your little world, Bubble Boy.

used to be when you went to a doctor, the MD took hand written notes , now everything goes into a laptop, right to the govt. your privacy is compromised. questions asked by the doctor ( a GP) on a recent visit,..........have you had sex in the last 12 months and if so, what type of birth control was used, what type of protection, was the sex with men, women or both? another question was asked ,....... do you own a gun? I was there for a visit concerning cholesterol. for an eye exam, you read the chart, have your pupils dilated to be examined for cataracts. .now there is charge for the dilation,.....new obamacare rules.

The only really odd question is the gun thing. If they were to ask if you had thoughts of suicide in addition to the gun thing it makes sense but on it's own? Sounds weird. Still, you're being a little paranoid. And who tells the truth about sex anyway? Just tell them something. I didn't have sex with that woman....Ms.....Lew...Anyway, republicans could have accomodated people with pre-existing conditions and we could have avoided all this Obamacare BS but they just don't care. Get a grip, really.

after being asked about owning a gun , i asked why the question, the doctor said it was a safety thing,..... i told her it was about knowing who hs guns and who doesnt.information that is a lot easier to get to when the info can be put into her govt supplied lap top. its not about telling the truth about sex, its that the questions are even asked.

this is obamacare, not private insurance. you have no problems with the questions asked by the doctor on behalf of the govt? no problem with the privacy of doctor patient relationship now being non existant?